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[Alterations of Lp (a) lipoprotein in patients with chronic renal failure treated by continuous ambulatory peritoneal
T Takegoshi1, C Kitoh, T Shimada
1Department of Internal Medicine, Fukui Prefectural Hospital, Japan.
Insights
Elevated Lipoprotein(a) [Lp(a)] levels are common in patients on continuous ambulatory peritoneal dialysis (CAPD), particularly diabetics. These higher Lp(a) levels may contribute to accelerated atherosclerosis in CAPD patients.
Area of Science:
- Nephrology
- Cardiology
- Clinical Chemistry
Context:
- Cerebrovascular and cardiovascular diseases are leading causes of mortality in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Elevated Lipoprotein(a) [Lp(a)] is associated with cardiovascular risk, especially in diabetic and proteinuric patients.
- Understanding Lp(a) levels in CAPD patients is crucial for assessing cardiovascular risk.
Purpose:
- To determine Lipoprotein(a) [Lp(a)] levels in patients on CAPD.
- To investigate the association between Lp(a) and traditional atherosclerotic risk factors in CAPD patients.
Summary:
- Serum Lp(a) levels were significantly elevated in CAPD patients compared to controls.
- Lp(a) levels were higher in diabetic CAPD patients and correlated positively with fasting blood sugar.
- No significant correlations were found between Lp(a) and other risk factors like age, BMI, blood pressure, or lipid profiles.
Impact:
- Elevated Lp(a) may be an independent risk factor for accelerated atherosclerosis in CAPD patients.
- This finding suggests that Lp(a) should be considered alongside other cardiovascular risk factors in managing CAPD patients.
- Further research may explore therapeutic strategies targeting Lp(a) to mitigate cardiovascular risk in this population.
Abstract:
Cerebrovascular and cardiovascular diseases are important predictors for survival in patients undergoing continuous ambulatory peritoneal dialysis (CAPD), and account for about half the deaths in these patients. Lipoprotein(a) [Lp(a)] is known to show high values in diabetics with proteinuria, and albuminuric renal disease. The purpose of this study was to determine Lp(a) levels and to investigate the association of Lp(a) and atherosclerotic risk factors in patients treated by CAPD. Lp(a) concentration were measured in 20 CAPD patients in the age range 31 to 83 years. Mean (+/- SD) levels of serum Lp(a) were elevated in the CAPD patients compared to age, sex matched 17 controls (49.5 +/- 27.7 vs. 15.5 +/- 12.4 mg/dl, p < 0.001). The levels of Lp(a) were significantly higher in the diabetic CAPD patients than in non-diabetics. There were significant positive correlations between serum Lp(a) concentrations and fasting blood sugar. However, when the above two groups were matched for age, sex, body mass index and FBS, Lp(a) concentrations were also significantly higher in CAPD patients than those in normal controls. We found no statistically significant correlations of Lp(a) with either age, body mass index, blood pressure, serum lipoprotein, apoprotein, glycated hemoglobin, BUN, creatinine or serum protein levels. There were no correlations between serum Lp(a) levels and albumin and LP(a) concentrations in the dialysate in all CAPD patients. Along with assessment of other known established cardiovascular risk factors such as elevated blood pressure, atherogenic abnormalities of plasma lipids and lipoproteins, and impaired glucose tolerance, we suggest that elevated levels of Lp(a) may lead to the accelerated atherosclerosis in these patients.